22nd April 2024

Fungal Disease of the mouth

Candidiasis is a fungal infection that is caused by the overgrowth of Candida species, the most common of which is Candida albicans. While Candida naturally resides on the skin and mucous membranes without causing harm in most individuals, certain conditions can lead to its proliferation and subsequent infection. The severity and manifestations of candidiasis can vary depending on the immune status of the affected individual, with immunocompetent and immunocompromised individuals presenting distinct clinical phenotypes. Patients with dentures or diabetes can be put at an augmented risk of oral candida. Immunocompetent individuals are capable of mounting an effective defence against Candida. In these individuals, candidiasis characteristically occurs in localised areas such as the oral cavity, known as oral thrush, as well as the vaginal area in women. Symptoms of infection may include white patches or plaques, pruritus, and discomfort in the affected areas. Immunocompetent individuals with candidiasis usually respond well to treatment with topical or oral antifungal agents, and the infection is generally self-limiting. Immunocompromised individuals allow Candida to invade deeper tissues and organs, leading to invasive candidiasis. This condition can occur in patients with underlying medical conditions such as HIV/AIDS, cancer, organ transplantation, or those receiving immunosuppressive therapy. Invasive candidiasis can manifest as bloodstream infections (candidemia), disseminated infections, or localised infections in specific organs such as the kidneys, liver, or lungs. Disseminated candidiasis requires intravenous fungal agents as well as a multidisciplinary approach involving infectious disease specialists, microbiologists, and other healthcare professionals, to guide appropriate treatment and monitor the response to therapy.